| Keith K. Ewell, Ph.d. | |
|
12700 Sabastian Dr Fairfax VA 22030-6610 | |
| (703) 322-0701 | |
| Not Available |
| Full Name | Keith K. Ewell, Ph.d. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 12700 Sabastian Dr, Fairfax, Virginia |
| Authorized Official Name and Position | Keith K. Ewell (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7033220701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith K. Ewell, Ph.d. 12700 Sabastian Dr Fairfax VA 22030-6610 Ph: (703) 322-0701 | Keith K. Ewell, Ph.d. 12700 Sabastian Dr Fairfax VA 22030-6610 Ph: (703) 322-0701 |
| NPI Number | 1265835219 |
|---|---|
| Provider Enumeration Date | 10/06/2014 |
| Last Update Date | 10/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265835219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 0810002479 (Virginia) | Primary |
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